■探讨雌二醇(E2)与成年女性高尿酸血症(HUA)发病率的关系,并探讨糖脂代谢紊乱是否在介导这种关系中起中介作用。
■共有2,941名20-65岁的参与者被纳入2013-2016年国家健康和营养检查调查(NHANES)。采用多因素logistic回归分析评价E2与HUA的相关性。采用多元线性回归分析评价E2与甘油三酯(TG)、总胆固醇(TC),和甘油三酯-葡萄糖指数(TyG)。利用约束三次样条(RCS)模型进一步探讨E2与HUA、TG,TC,TyG和HUA.进行了中介分析,以检查TC,TG,TyG介导E2与HUA的关系。
■调整协变量后,logistic回归显示,ln(E2)与女性亚组的HUA显着相关(p=0.035),并且HUA的发生率随着ln(E2)的降低而增加(p为趋势=0.026)。线性回归显示E2与TC显著相关(p=0.032),TG(p=0.019),和TyG(p=0.048)。RCS模型显示ln(E2)与HUA的发生率呈线性相关(p总体=0.0106,p非线性=0.3030)。TC和TyG与HUA呈线性相关(TC:p总体=0.0039,p非线性=0.4774;TyG:p总体=0.0082,p非线性=0.0663),而TG与HUA呈非线性相关。中介分析显示,TC,TG,和TyG显著介导ln(E2)和HUA(TC,间接效应:-0.00148,7.5%,p=0.008;TG,间接效应:-0.00062,3.1%,p=0.004;TyG,间接效应:-0.00113,5.6%,p=0.016)。
■总而言之,这项研究表明,与20-45岁的女性相比,45~55岁和55~65岁女性的E2水平较低,HUA发生率较高.E2水平和HUA的发生率在女性个体中呈负相关,而在男性个体中没有。此外,TC,TG,和TyG,它们是糖脂代谢的标志,在E2和HUA之间的关系中起中介作用。
UNASSIGNED: To explore the relationship between estradiol (E2) and the incidence of hyperuricemia (HUA) in adult women and to explore whether glucolipid metabolism disorders play a mediating role in mediating this relationship.
UNASSIGNED: A total of 2,941 participants aged 20-65 years were included in the National Health and Nutrition Examination Survey (NHANES) 2013-2016. Multivariate logistic regression analysis was performed to evaluate the correlations of E2 with HUA. Multivariate linear regression analysis was performed to evaluate the associations between E2 and
triglyceride (TG), total cholesterol (TC), and the
triglyceride-glucose index (TyG). The restricted cubic spline (RCS) model was used to further explore the association between E2 and HUA and between TG, TC, and TyG and HUA. Mediation analyses were performed to examine whether TC, TG, and TyG mediated the relationship between E2 and HUA.
UNASSIGNED: After adjusting for covariates, logistic regression revealed that ln(E2) was significantly associated with HUA in the female subgroup (p = 0.035) and that the incidence of HUA tended to increase with decreasing ln(E2) (p for trend = 0.026). Linear regression showed that E2 was significantly associated with TC (p = 0.032), TG (p = 0.019), and TyG (p = 0.048). The RCS model showed that ln(E2) was linearly correlated with the incidence of HUA (p-overall = 0.0106, p-non-linear = 0.3030). TC and TyG were linearly correlated with HUA (TC: p-overall = 0.0039, p-non-linear = 0.4774; TyG: p-overall = 0.0082, p-non-linear = 0.0663), whereas TG was non-linearly correlated with HUA. Mediation analyses revealed that TC, TG, and TyG significantly mediated the relationship between ln(E2) and HUA (TC, indirect effect: -0.00148, 7.5%, p = 0.008; TG, indirect effect: -0.00062, 3.1%, p = 0.004; TyG, indirect effect: -0.00113, 5.6%, p = 0.016).
UNASSIGNED: In conclusion, this study demonstrated that compared with women aged 20-45 years, women aged 45-55 years and 55-65 years had lower E2 levels and a greater incidence of HUA. E2 levels and the incidence of HUA were negatively associated in female individuals but not in male individuals. In addition, TC, TG, and TyG, which are markers of glucolipid metabolism, played a mediating role in the association between E2 and HUA.